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Home My WebLink About18395 --��__-, CITY OF DIAMOND BAR �Q�'� DEPARTME?`i'T OF COMMUNI'fY&DEVELOPMENT SERVICES 21825 E.Copley Drive '� (909)860-3195 Fax(909)861-3117 � PRESS �''%�� BUILDING PERMIT APPLICATION � 6 F LY o AD RIESS � ��v '"-1U,N��I�I�d�I` �IM�lJ (J ��ATIO � � NU B R �/C � ISSUE TYPE pCC APN LOT TRACT _ DATE ( CONST. GROUP p OWNER p ADDRESS - � I �� ZONING SETBACKS Z CITY ZI �TEL. FRONT qyy p g APPLICANT TEL. REAR p dz SIDEJSIDE STREET RW O � CONTRACTOR SIDE p ADDRESS O PROPOSED USE ��- � CITY ZIP TEL. \ T� oARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLAAATION SFR/ADD/REM _ O p I NEREBV AFFlRM UNDER PENALTV OF PERIURV THAT I AM EXEAIPT FROM THE COMRACTOqS L�� G8f8gB/COfpOfl W CENSEUWFORTHEFOLLOWINGREASON(SEC.70.31.SBUSINESSMlDFROFESSIONS�'ADE:ANVCITVOR (n U COUN7YWHIq1RC-0UIRESAPERMITTOCONSTRUCT,AITER,IMOROVE,OEMOLISM,ORREPAIRANVSTRUG w TURE,PRIDR TO ITS ISSUANCE,AL50 REQUIRES THE APPUCANT FOR SUCH PERMIT TO FILE A SIGNED w P8I10/DBCI( � STATEMENT THAT HE OH SHE IS LICENSED PURSUMlT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE UW(CHAPTEFi�(COMMENCING WITH SECTION 7oao)OF�IVISION J OF THE BUSINESS AND PRO� � POOUSp2 � FESSIONSCQDE)ORTHATHEORSHEISEXEMPTTH�REFROMANDTNEBASISFOPTHEALLEGEDEXEMP� (!3 V TION.ANVVIOLATIONOFSECTION7031.SBYANVAPPUCAN,-FORAPEPMITSU9JECT5'fHEAPPLICANTTO Z Re-Roof . � A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLURS(f500).J: � ,��. ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESW17HWAGESASlHE1R50LECOMPENSATiON, � Commercial Z WILL DO THE WORK,AND THE S7RUCTURE IS NOT IMENDED OR OFFERED FOH SALE(SEC.7oat,BUSI� J � NESS AND PROFESSIONS CODE:7HE CONTRACTORS LICENSE LAW DOES NO'APPLV TO AN OWNER OF � PHOPERTV NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREOFORSALEIF,HOWEVERTMEBUILDINOORIMPROVEMENTISSOI.DWITHINONEVEAROFCOMPLE- Z TKKJ.THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING'HAT HE OR SHE DID NOT 9UILD OR , � IMPROVE FOR THE PURPoSE OF SALE). ' w ❑I,ASONTJEROFTHEPROPEHTY,AMEXCLUSNELVCONTRACTINGWITHLICENSEDCONTRACTORS [t TO CONSTRUCT THE PRQIECT(SEC.7oN,BUSINESS AND PROFESSIONS CODE:TNE COM7'RACTORS LI� V01U0�iOf1 � ADJ.AREA - W CENSELAWOOESNOTAPPLYTOANOWNEROFAPROPERTYWHOaVII.DSOFIMPROVESTHEREON,AND — = NM1iOCONTMCTSFORSUCHPROJECTSWITHACANTRACTOR�S)LICENSEDPURSUANTTOTHECONTRAC� FEE ~ TORS UCENSE LAW.). OUANTITY DESCRIPTION Y Q ❑I AM EXEMPT UNDER SEC. B.d V.C.FOR THIS REASON Q � U � H U �Q LIC CONTRACTORS DECLARATION W 2 I HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROViSIONS OF CHAGTER � d o(COMMENCINO WITH SECTION 7000)OF OIVISION�OF THE BUSINESS AND PP.OFESSiOIJS CODE,AND `X MV LICENSE IS W FUIL FORCE AND EFFECT. � LICENSE CLASS _ LIC.NO. V DATE CONTRACTOR W • � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBV AFFIRM UNDER PENALTV OF PERIURY ONE OF THE fOLLOWING DECLARATIONS: Z �Z I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' ¢ Q = COMPENSATION,AS PROVIDED BV SECTION J7oo OF TME LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � Qw I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REOl11RED BV SECTION 370o OF THE LABOR CADE.FOR THE PEflFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBEF ARE: CONSTRUCTION � CARRIER PLAN REVIEW � ZPOUCVNUMBER ELECTRIC Q � (�H55ECTqNn7E�NoiBE001.wLE7EDOFnEVEw.ttlSfoqoNEtunOaED0a1nR5(fiao�OR�Ess�. PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH TNIS PERMIT IS ISSUED,1 MECHANICAL C} SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECAME SUBJEC.T TO THE � N'ORKERS'COMFENSATIONLAWSOFCALIFORN10.�NDAGREETMATIFISHWLDBECOME INS?ECTIONFEE '� SU&IECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3]00 OF THE UBOR �� CODE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE ' � p� DATE: APPLICANT: SMIP W J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERACE IS UNUWFUL,AND SHALL BE ENERGY P/C J � SU&IECTANEMPLOVEFTOCRIMWALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100,o00),IN ADDITION TO THE COST OF COMPENSATqN,DAMAGES AS PROVIDED FOR IN J SECTION 3]OB OF THE LABOR CODE.MTEREST,AND ATTORNEV'S FEES. OC RETENTION FEE: w O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � � 1 HEFEBV AFFIRM UNOER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WOFK FOR WHICM THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�. Z W � LENDER'S NAME ' F-- LENDER'SADDRESS w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CAqRECT. TOTAL FE ES � � I AGREE TO COMPLV WITH ALL CRV AND CWNTY ORDINANCES AND STATE UWS RELATMG TO BVILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CIXINTV TO ENTER UPiJN THE �L � Z ABO �MENTIONED PROPERTY FOR INSPECTION PURPOSES. 0 � ' � ��J� �/ COMMENTS � l�1��v RMITfEE NAME �i � � � � ^ `1 � rV SIGNATURE OF PERMITT E DATE RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLOENRO ile Copy,GREEN—ApplicanYs Copy �9`��f O� E39,�i�d��9� �AF$ �ft�SP�C`�'B��( �l�CC96-�D � .� � �� - .H � � --�., , _ . . . . , , e ��.��. , � �.� O � � ' � O t� "- ° d ...;_ ' D Q : . � _ , D � ., , � . > - , ,. _ , �., . , ._ , ,. . , . ., ,.. . . . .., �,,_ � SET BACK � �j � FLOOR JOIST ' � FTGS/�ORMS/STEEL I FNA REQMTS ELECTRIC GROUND i ` � � UNDER FLCOR DUCT . _ GROUND PLllMBING � � UNDER FLOOR CUt�IDUIT . . � SLAB GRADE ` j FIREF�ACF FOUNDATION TEMP POWER _�FIREPLACE BUND BEAM WATER SERVICE - � �--MID NT. BC)ND E3EAM ROOF SHEATHING � ^ i 8 FT. BOND BEAM � FRAMING/VENTILIATION FINA�. BOND BEAM ROOF COVER � PRE-GRAQING ROUGH HEATING , BENGNING ROUGH ELECTRIC ��_ � ROUGH GRADING ROUGH PLUMBItVG ��+�D�� F!NlSN GRADING ��_ _ _ SHOWER/TUB TEST ^i— POOL ELECTRIG EXT. LATHlSlDING POOI FENCING WALL INSULATION � � POOL FINAL ` CEILING IN�ULATION OFF SITE IMPS. DRYWALL NAIUNG � aEDIG7�JIQNS� ^ SEWER FINAL ENG. SEPTIC TANK v� � LANDSCAPEIIRRIG. ! SEEP PIT/L.�. � ON SITE IMPS. r___� GAS AIR TEST gl�z J�L Q� N �INAL ZONING FINAL CaNST. � � FIRE DEPT. FINAL ______.a_.�__� _ _i___� F(NAL HEATtNG `� ! � HEALTH DEP7. FINAL� FiNAL ELECTRIC � � � DEV. FEES PAID FINAL PLUMSING �-' �� ENERGY � � - — -- - 4 , � a •�-e'. �u.'�, CUMfViENTS _�_Q•92- ��c,°i;, r�11�sw.��_� � � SEPTIC TANK SIZE SEEP PIT/U SIZE > �. . �UV�� -. '.._ � . -�,._ . , ' V., ,-��.��- r>"... . t"-' �'. �• • ' �,. = 1 �?=�� .: . "'�� --- ----- --- � � �y.;� � . b� . y� �� :_F;